Frequency of Superior Vena Cava Obstruction in Pediatric Heart Transplant Recipients and Its Relation to Previous Superior Cavopulmonary Anastomosis

The risk factors for superior vena cava (SVC) obstruction after pediatric orthotopic heart transplantation (OHT) have not been identified. This study tested the hypothesis that pretransplant superior cavopulmonary anastomosis (CPA) predisposes patients to SVC obstruction. A retrospective review of t...

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Bibliographic Details
Published in:The American journal of cardiology 2013-07, Vol.112 (2), p.286-291
Main Authors: Aldoss, Osamah, MD, Arain, Nofil I., MD, Vinocur, Jeffrey M., MD, Menk, Jeremiah, MS, Ameduri, Rebecca K., MD, Bryant, Roosevelt, MD, Kochilas, Lazaros K., MD, Gruenstein, Daniel H., MD
Format: Article
Language:English
Subjects:
Adolescent
Age
Cardiovascular
Child
Child, Preschool
Cohort Studies
Confidence intervals
Defects
Female
Gender
Heart
Heart Bypass, Right - adverse effects
Heart surgery
Heart Transplantation - adverse effects
Humans
Infant
Male
Retrospective Studies
Superior Vena Cava Syndrome - epidemiology
Superior Vena Cava Syndrome - etiology
Transplants & implants
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Summary:The risk factors for superior vena cava (SVC) obstruction after pediatric orthotopic heart transplantation (OHT) have not been identified. This study tested the hypothesis that pretransplant superior cavopulmonary anastomosis (CPA) predisposes patients to SVC obstruction. A retrospective review of the Pediatric Cardiac Care Consortium registry from 1982 through 2007 was performed. Previous CPA, other cardiac surgeries, gender, age at transplantation, and weight at transplantation were assessed for the risk of developing SVC obstruction. Death, subsequent OHT, or reoperation involving the SVC were treated as competing risks. Of the 894 pediatric OHT patients identified, 3.1% (n = 28) developed SVC obstruction during median follow-up of 1.0 year (range: 0 to 19.5 years). Among patients who developed SVC obstruction, 32% (n = 9) had pretransplant CPA. SVC surgery before OHT was associated with posttransplant development of SVC obstruction (p 
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2013.03.029